{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T01:36:01Z","timestamp":1793237761762,"version":"4.5.0"},"reference-count":57,"publisher":"BMJ","issue":"15","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2016,4,27]]},"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The decision as to whether or not an athlete is ready to return to sport (RTS) after ACL reconstruction is difficult as the commonly used RTS criteria have not been validated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>To evaluate whether a set of objective discharge criteria, including muscle strength and functional tests, are associated with risk of ACL graft rupture after RTS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>158 male professional athletes who underwent an ACL reconstruction and returned to their previous professional level of sport were included. Before players returned to sport they underwent a battery of discharge tests (isokinetic strength testing at 60\u00b0, 180\u00b0 and 300\u00b0\/s, a running t test, single hop, triple hop and triple crossover hop tests). Athletes were monitored for ACL re-ruptures once they returned to sport (median follow-up 646\u2005days, range 1\u20132060).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 158 athletes, 26 (16.5%) sustained an ACL graft rupture an average of 105\u2005days after RTS. Two factors were associated with increased risk of ACL graft rupture: (1) not meeting all six of the discharge criteria before returning to team training (HR 4.1, 95% CI 1.9 to 9.2, p\u22640.001); and (2) decreased hamstring to quadriceps ratio of the involved leg at 60\u00b0\/s (HR 10.6 per 10% difference, 95% CI 10.2 to 11, p=0.005).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Athletes who did not meet the discharge criteria before returning to professional sport had a four times greater risk of sustaining an ACL graft rupture compared with those who met all six RTS criteria. In addition, hamstring to quadriceps strength ratio deficits were associated with an increased risk of an ACL graft rupture.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bjsports-2015-095908","type":"journal-article","created":{"date-parts":[[2016,5,23]],"date-time":"2016-05-23T23:54:14Z","timestamp":1464047654000},"page":"946-951","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":742,"title":["Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture"],"prefix":"10.1136","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7765-9407","authenticated-orcid":false,"given":"Polyvios","family":"Kyritsis","sequence":"first","affiliation":[{"name":"Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roald","family":"Bahr","sequence":"additional","affiliation":[{"name":"Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"},{"name":"Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sports Science, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Landreau","sequence":"additional","affiliation":[{"name":"Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riadh","family":"Miladi","sequence":"additional","affiliation":[{"name":"Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Witvrouw","sequence":"additional","affiliation":[{"name":"Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"},{"name":"Department of Physical Therapy and Motor Rehabilitation, Ghent University, Gent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,5,23]]},"reference":[{"key":"2025080114360888000_50.15.946.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.09.009"},{"key":"2025080114360888000_50.15.946.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-014-1992-x"},{"key":"2025080114360888000_50.15.946.3","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20140124-10"},{"key":"2025080114360888000_50.15.946.4","doi-asserted-by":"publisher","DOI":"10.1007\/s001670000130"},{"key":"2025080114360888000_50.15.946.5","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-093398"},{"key":"2025080114360888000_50.15.946.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2005.04.110"},{"key":"2025080114360888000_50.15.946.7","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2009.070672"},{"key":"2025080114360888000_50.15.946.8","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506296042"},{"key":"2025080114360888000_50.15.946.9","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1177\/03635465030310063901","article-title":"Clinical, functional, and radiologic outcome in team handball players 6 to 11 years after anterior cruciate ligament injury a follow-up study","volume":"31","author":"Myklebust","year":"2003","journal-title":"Am J Sports Med"},{"key":"2025080114360888000_50.15.946.10","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2005.021055"},{"key":"2025080114360888000_50.15.946.11","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507301318"},{"key":"2025080114360888000_50.15.946.12","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510379975"},{"key":"2025080114360888000_50.15.946.13","doi-asserted-by":"crossref","unstructured":"Wiggins AJ , Grandhi RK , Schneider DK , et al . 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